This presentation addresses the biopsychosocial aspects of chronic abdominal pain. Using a case based format, the lecture covers the full dimensionality of the development, pathogenesis, clinical and physiological aspects chronic abdominal pain in a woman with a history of early trauma and psychosocial comorbidities. It discusses brain gut physiology with regard to pain signaling pathways, central modulation of pain, neuroplasticity and neurogenesis. Following this the lecture addresses associations of the pain with other conditions including opioid induced constipation and narcotic bowel syndrome. Finally the lecture concludes with a management approach using centrally targeted treatments.